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orate or calitornia - CIWMB Form 83 (rev. 12/96) <br />Registration Permit Application <br />California Integrated Waste Management Board <br />racllrry Name: L y -e 12y? -� fay P ^1 <br />C C,1r e: r✓, <br />Address/Location: 20 Ujuo r6l Dr- -fyaN CA Cj Cj2�Ut 1 <br />Phone Number. C 6 [p> —1 -FA <br />Facility Operator�� <br />Mailing Address: ?b <br />l l V\-; (M c-t:� <br />Address Where Process May be Served: -%, a (o 4 <br />Phone Number.6�10 <br />Facility Information: <br />Section Authorizing Eligibility: J -1--i5 5 -'-! <br />Volume and Type of Waste/MMedais(s) Handled: <br />Site Capacity: IQ <br />Peak <br />Cubic Yards Tons <br />Peak Loading: t - 2�- Cubic Yards 0 Tons /Day <br />Annual Loading: 1 <br />6, awcublc Yards or Tons <br />Days and Hours of Operation: <br />Land Omer .1--IroI iy Co viey)f'X'C2 C6-i4e t - LLC. <br />Mailing Address; 2 ( L%, u e4r- Ct ind e <br />Su�3- Z <br />�-(LT�\4f-H-, CA qq5 y 4 <br />Address Where Process May be Served: <br />cJ Gt-vy�_ &-s <br />Phone Number. D <br />Facility Size: 2JD Area <br />Operating Area: =Area <br />Traffic: <br />Incoming Waste Material: Vehicles Per Day <br />Outgoing Waste Material: Vehicles Per Day <br />One of the Following Statements Must be Checked: <br />(] The facility is identified and described in or conforms with the County Solid Waste Management Plan, or otherwise complies with Public Resources <br />Code 50000; and the facility is consistent with the city or county General Plan. <br />[ J The facility is identified in either the countywide sifting element, the nondisposal facility element, or in the source reduction and recycling element for <br />the jurisdictions in which his located ;or that the facility is not required to be identified in any of these elements pursuant to section 50001 of the <br />Public Resources Code. <br />I hereby acknowledge that I have read this application, and certify under penalty "jury that the information provided is true and accurate. In operating <br />the facility, I agree to comply with the conditions Ire p�rmit, andeq dera th, and local enactments <br />Signature of Land Owner. <br />Signature of Operator. <br />This application must be accompanied by a <br />Enforcement Agency Name and Address: <br />Site Plan, and Location Map. <br />%6 - <br />FOR ENFORCEMENT AGENCY USE ONLY <br />Date received: <br />Date approved: <br />Date rejected: <br />Filing Fee: <br />SWIS #: <br />Date: ! /'�Z / <br />q 6 <br />